Removal or Nonremoval of the Rib During a Direct Lateral Interbody Fusion Relative to Postoperative Pain.

Study Design: Retrospective chart review.

Objective: To determine whether there was a difference in postoperative pain among patients undergoing direct lateral interbody fusion (DLIF) who had rib removal compared with those who did not.

Background: DLIF is a minimally invasive, lateral transpsoas surgical approach for spinal fusion that has a lower 2-year pain rating when compared with an open procedure.

Utilization of the Nurse Champion Model to Improve Developmentally Supportive Positioning in the NICU.

This evidence-based project was implemented and evaluated the impact of using the nurse champion model to increase compliance and facilitate best practices for developmental positioning in the NICU. Education provided by a newly developed nurse champion team reinforced the knowledge and skills needed to use developmental positioning. Measurements included compliance with documentation about positioning, nurse champions' effectiveness, and intent to use the nurse champion model.

Risk Factors Associated with Pyogenic Spinal Infections among Intravenous Drug Users and Nonusers.

Purpose: To identify the differences in patient factors, presentation, treatment course, and outcomes of intravenous drug users (IVDA) vs. nonusers (non-IVDA) presenting with pyogenic spinal infections. .

Human Factors Validation of a Wearable, On-Body Infusor for Subcutaneous Administration of Furosemide.

Purpose: Furoscix (subcutaneous furosemide) is administered using a wearable On-Body Infusor (OBI) and is approved for the treatment of congestion associated with heart failure (HF). The purpose of this study was to assess the safe and effective use of the OBI and Instructions for Use (IFU) by patients with HF, caregivers, and healthcare practitioners (HCPs).

Methods: Sixty participants (patients, n=30; caregivers, n=15; HCPs, n=15) were evaluated on completion of OBI use tasks and IFU knowledge tasks in a simulated use environment.

Farmworker-Relevant Heat Exposure in Different Crop and Shade Conditions.

Objectives: Agricultural workers are at risk of heat-related illness, which is preventable. Few field studies have compared farmworker-relevant heat exposure in different conditions. We examined heat exposure over time in different potential shade and work locations to inform future occupational heat prevention approaches.

Multicenter expanded access program for access to investigational products for amyotrophic lateral sclerosis.

Introduction/aims: Expanded access (EA) is a Food and Drug Administration-regulated pathway to provide access to investigational products (IPs) to individuals with serious diseases who are ineligible for clinical trials. The aim of this report is to share the design and operations of a multicenter, multidrug EA program for amyotrophic lateral sclerosis (ALS) across nine US centers.

Methods: A central coordination center was established to design and conduct the program.

Silver carboxylate-TiO/polydimethyl siloxane is a safe and effective antimicrobial with significant wound care potential.

Introduction: With the rise in antibiotic resistance, new methodologies are needed to combat musculoskeletal infections. Silver is an antimicrobial that can be synthesized in different forms, but its pharmacokinetics are difficult to control. This study details the antibacterial efficacy and cellular cytotoxicity of a formulation consisting of silver carboxylate (AgCar) released through a titanium dioxide/polydimethylsiloxane matrix with a predictable release profile on , , human-derived primary osteoblasts.

Prospectively Collected Comparison of Outcomes Between Surgically and Conservatively Treated Patients With Adolescent Idiopathic Scoliosis.

Study Design: Retrospective review of a prospectively collected multicenter registry.

Objective: To evaluate health-related quality of life (HRQOL) measures in an operative cohort of patients (OP) and compare them with a matched nonoperative cohort (NON).

Summary Of Background Data: Historically, the surgical outcomes of adolescent idiopathic scoliosis (AIS) have been radiographically evaluated.

Late-onset facioscapulohumeral muscular dystrophy type 1 in previously undiagnosed families: Presenting clinical features in an often-misdiagnosed disorder.

Introduction/aims: In our experience, patients with late-onset facioscapulohumeral muscular dystrophy type 1 (FSHD1) are frequently misdiagnosed, some for many years. The aim of this report is to document this clinical experience including the presenting symptoms and misdiagnoses and to discuss the challenges in diagnosing patients with late-onset FSHD1.

Methods: We performed a retrospective medical record review and recorded clinical data on patients with a genetically confirmed diagnosis of FSHD1, who began to have symptoms at 50 years of age or older, and either had no family history of FSHD1 or had a history of an undiagnosed weakness in a family member.

Day one versus day zero postoperative physical therapy among patients with lumbar spinal fusion: a length of stay comparison.

Background Context: Postoperative physical therapy (PT) following lumbar spinal fusion is an effective form of postoperative rehabilitation. However, it is unknown when a postoperative PT protocol should be optimally initiated.

Purpose: This study sought to compare lengths of stay between patients on a day zero PT protocol and those on a day one PT protocol.

Mitochondrial dysfunction in animal models of PTSD: Relationships between behavioral models, neural regions, and cellular maladaptation.

Post-traumatic stress disorder (PTSD) is a trauma-related condition that produces distressing fear memory intrusions, avoidance behaviors, hyperarousal, stress responses, insomnia and other symptoms. This review of rodent models of PTSD examines trauma effects on fear-related learning, cognition, and avoidance, emotional and arousal behaviors and on mitochondrial dysfunction in relevant neural pathways. The review focuses on research that includes four elements: consensus PTSD rodent models, behavioral phenotyping, mitochondrial dysfunction within key neural regions.

Training Health Care Practitioners to Include Family Caregivers With Web-Based Learning Modules.

Background Caregivers play a key role in supporting patient health; however, they have largely been excluded from participating in health care teams. This paper describes development and evaluation of web-based training for health care professionals about including family caregivers, implemented within the Department of Veterans Affairs Veterans Health Administration. Systematically training health care professionals constitutes a critical step toward shifting to a culture of purposefully and effectively utilizing and supporting family caregivers for better patient and health system outcomes.

Silver Carboxylate as an Antibiotic-Independent Antimicrobial: A Review of Current Formulations, Efficacy, and Clinical Relevance.

The increasing prevalence of multi-drug resistant pathogens has led to a renewed focus on the use of silver as an antibiotic-independent antimicrobial. Unfortunately, the use of many silver formulations may be limited by an uncontrolled release of silver with the potential for significant cytotoxic effects. Silver carboxylate (AgCar) has emerged as an alternative formulation of silver with the potential to mitigate these concerns while still displaying significant bactericidal activity.

Systemic infection caused by the methicillin-resistant Staphylococcus aureus USA300-LV lineage in a Brazilian child previously colonized.

The methicillin-resistant Staphylococcus aureus (MRSA) USA300-Latin American variant (USA300-LV) lineage is well documented in northern Latin American countries. It has replaced established clones in hospital environments. We herein report a systemic infection caused by a USA300-LV isolate in a 15-year-old boy, from a low-income area of Rio de Janeiro, previously colonized by the same strain.

Silver Carboxylate-Eluting Titanium-Dioxide Polydimethylsiloxane Coating Inhibits Multi-Drug-Resistant and Vancomycin-Resistant Adherence and Proliferation on Orthopedic Trauma Fixation and Spinal Fusion Materials.

Vancomycin-resistant and multi-drug-resistant (MDR) are rising contributors to spinal fusion and fracture-associated infections (FAI), respectively. These MDR bacteria can form protective biofilms, complicating traditional antibiotic treatment. This study explores the effects of the antibiotic-independent antimicrobial silver carboxylate (AgCar)-doped coating on the adherence sand proliferation of these pathogens on orthopedic implant materials utilized in spinal fusion and orthopedic trauma fixation.

Patient Controlled Analgesia and an Alternative Protocol: A Comparison of Outcomes After Thoracic and Lumbar Surgery.

Introduction: Patient controlled analgesia (PCA) is a common form of pain management after spine surgeries, in which patients get custom control of their opioid dose. PCA has been demonstrated as a safe form of analgesia; however, use of PCA comes with risks that can be mitigated by opting for alternative pain management. This study aimed to compare the outcomes of patients using PCA to those with an alternative analgesia protocol that does not involve PCA.

Incidence of thrombotic complications related to weight-based dosing of activated prothrombin complex concentrate (aPCC) for reversal of apixaban and rivaroxaban in obese patients.

Factor eight inhibitor bypassing activity (aPCC) is recommended as a non-specific reversal agent for direct oral anticoagulants (DOACs) according to the 2017 American College of Cardiology (ACC) guidelines for reversal of anticoagulation. Factor eight inhibitor bypassing activity carries a black box warning for thrombotic events such as stroke, pulmonary embolism, deep vein thrombosis, and myocardial infarction, particularly at high doses. This was a retrospective, single-center, cohort investigation that included patients who received a weight-based dose of aPCC for reversal of apixaban and rivaroxaban between January 1, 2015, and December 31, 2020.

Family Caregiver and Provider Perspectives on Inclusive Care: Aligning Needs and Expectations.

Background: Home-based and community-based health care for individuals with complex medical conditions is often provided by family caregivers. Yet caregivers often are not meaningfully included in interactions with clinical health care teams. Inclusive care means inviting the caregiver to participate in shared decision-making and treatment planning.

Characterization of Tbr2-expressing retinal ganglion cells.

The mammalian retina contains more than 40 retinal ganglion cell (RGC) subtypes based on their unique morphologies, functions, and molecular profiles. Among them, intrinsically photosensitive RGCs (ipRGCs) are the first specified RGC type emerging from a common retinal progenitor pool during development. Previous work has shown that T-box transcription factor T-brain 2 (Tbr2) is essential for the formation and maintenance of ipRGCs, and that Tbr2-expressing RGCs activate Opn4 expression upon native ipRGC ablation, suggesting that Tbr2 RGCs contain a reservoir for ipRGCs.

Diagnostic yield of advanced genetic testing in patients with hereditary neuropathies: A retrospective single-site study.

Introduction/aims: Advanced genetic testing including next-generation sequencing (AGT/NGS) has facilitated DNA testing in the clinical setting and greatly expanded new gene discovery for the Charcot-Marie-Tooth neuropathies and other hereditary neuropathies (CMT/HN). Herein, we report AGT/NGS results, clinical findings, and diagnostic yield in a cohort of CMT/HN patients evaluated at our neuropathy care center.

Methods: We reviewed the medical records of all patients with suspected CMT/HN who underwent AGT/NGS at the Hospital for Special Care from January 2017 through January 2020.

Rod and Cone Connections With Bipolar Cells in the Rabbit Retina.

Rod and cone pathways are segregated in the first stage of the retina: cones synapse with both ON- and OFF-cone bipolar cells while rods contact only rod bipolar cells. However, there is an exception to this specific wiring in that rods also contact certain OFF cone bipolar cells, providing a tertiary rod pathway. Recently, it has been proposed that there is even more crossover between rod and cone pathways.

Myotonic Muscular Dystrophy Type 2 in CT, USA: A Single-Center Experience With 50 Patients.

Myotonic dystrophy type 2 (DM2) is an autosomal dominant disorder due to a (CCTG)n repeat expansion in intron 1 of the CNBP gene. In this article, we report the clinicopathologic findings in 50 patients seen at a single site over a 27 year period. DM2 was the fifth most common type of muscular dystrophy seen at our center with a 5-fold lower frequency as compared to DM1.